THE MAGNITUDE AND RISK FACTORS OF BRUCELLOSIS IN URBAN AND PERI-URBAN CATTLE IN NORTHERN AND EASTERN UGANDA BY DENIS RWABIITA MUGIZI (PhD STUDENT) 1 BACKGROUND • Agriculture = backbone of developing economies • Livestock supports 70 % of the world’s poor • Livestock contribute 5.2% of Uganda’s GDP • Most of the livestock products in Uganda are produced by small holder farmers. 2 Problem statement • Civil strife in Northern and Eastern Uganda concentrated the small holder farmers in and around towns in these areas • Genesis of urban and peri-urban farming in these areas • Need for food was further enhanced by the ensuing rural-urban migration 3 Problem statement Ctd… • Urban and peri-urban livestock farming is the major source of unprocessed foodstuffs in these towns • High disease burden including zoonotic ones • Brucellosis 4 Bovine brucellosis • Caused by biovars of Brucella abortus, B. melitensis and B. suis • Causes abortion, mastitis, placentitis, orchitis and hygromas in cattle • Causes relapsing fever and abortion in humans • Its zoonotic nature and resulting infertility in cattle impact on people’s livelihoods and health. 5 Objectives • Determine the sero-prevalence of brucellosis in indigenous and imported cattle in urban and periurban areas of Gulu and Soroti towns in Uganda. • Identify the associated risk factors for transmission of brucellosis in cattle in the study areas. 6 Objectives ctd ... • Isolation, biotyping and molecular characterization of the Brucella infecting cattle in the study areas. • Determine the susceptibility of Brucella isolates to commonly used anti-microbials in Uganda. • Disseminate research information to the various stakeholders so as to initialize mitigation strategies against brucellosis in cattle. 7 Significance of the study • Findings will be a starting point towards improvement of people’s livelihoods and public health 8 Study area 9 Production system & Climate • Dry climatic (21.5-34o C) • Bimodal annual, rainfall of 700-800mm 10 Study design ctd • Collected samples • Lab. analyses RB plate test i-ELISA c-ELISA Culture and isolation Drug susceptibility Molecular typing 11 Drug susceptibility testing • Was carried out using the MIC broth micro-dilution panel method. • The panel consisted of commonly used antimicrobials in Uganda e.g. Gentamycin, Streptomycin, Tetracycline, Rifampicin, Penicillin, Ampicillin, Trimethoprim and Ciprofloxacin. 12 DNA extraction and molecular typing • Genomic DNA was extracted from colonies using the Norgen DNA extraction kit • Isolates confirmed as Brucella using real time PCR (Probert et al., 2004). • A Multiplex PCR (Bruce-ladder) protocol was used (Lopez Goni et al., 2008) for speciation • Biovar and genotype identification was done using the MLVA-16 assay (Le Fleche et al., 2006). 13 DATA ANALYSIS • The data collected was captured in Excel & transferred into SPSS version 17 for windows • Univariable and multivariable analyses (Logistic regression) were used to establish relationship between disease out come and risk factors 14 RESULTS • Sero-positivity was significantly (p < 0.001) higher in Soroti than Gulu. Number of included herds and animals and Brucella sero-prevalence District Gulu Soroti Overall Herds sampled 116 50 166 Serum samples 500 507 1007 Herd sero-prevalence 19% 46% 27% Animal sero-prevalence 6% 9% 7.5% 15 Multivariable analyses of herd and individual animal risk factors for Brucella seropositivity in cattle in Gulu Variable Category p-value OR 95% C.I for OR Lower Upper Herd level Herd size 0.03 1 - 5 cattle (ref) - 1.0 - - 6 - 10 cattle 0.998 < 0.0001 < 0.0001 < 0.0001 11 - 20 cattle 0.22 2.6 0.6 12 > 20 cattle 0.002 7.8 2 29 Individual animal level Age 0.002 1 - 2 years (ref) - 1.0 - - >2 - 5 years 0.12 0.4 0.1 1.3 >5 - 7 years 0.28 1.9 0.6 6.6 > 7 years 0.09 3.0 0.9 11 Region of origin of the cow < 0.0001 Western Uganda (ref) - 1.0 - - Central Uganda 0.3 0.5 0.1 1.8 Northern Uganda < 0.0001 0.1 0.05 0.4 16 Multivariable analyses of herd and individual animal risk factors for Brucella seropositivity in cattle in Soroti Variable Category p-value OR 95% C.I for OR Lower Upper Herd level Introduction of new cattle in last 2 years Keeping pigs No (ref) - 1.0 - - Yes 0.01 6.8 1.6 29.5 Yes (ref) - 1.0 - - No 0.02 4.9 1.2 19 17 Isolates • 11 isolates obtained from 207 milk samples (5.3%) • All the isolates were from sero-positive cattle (11/17) • All isolates were bio-typed and confirmed with monospecific sera as B. abortus 18 Drug susceptibility of isolates MIC (µg/ml) for B. abortus isolates Antimicrobial Isolate range (µg/ml) CLSI recommended susceptibility break point No. of isolates with MIC above the CLSI values Ampicillin 64-128 0.25-8 11 Ciprofloxacin 0.5-1 0.12-1 0 Gentamicin >16 ≤4 11 Streptomycin >256 ≤8 11 Tetracycline 2-4 ≤1 11 Florfenicol 16-32 --------- --------- Sulfamethoxazole >1024 ≤0.056-0.1 11 Trimethoprim 8-16 0.05 11 Chloramphenicol >64 0.25-4 11 Cefotaxime >2 0.5-2 11 Ceftazidime >16 ------- --------- Penicillin >16 0.25-8 11 Linezolid >16 ------- --------- Rifampicin 2-4 0.06-4 0 19 Bruce-ladder agarose gel picture 20 Gel picture showing MLVA-16 assay; locus 1-6; extreme left, right and intermedite lanes = ladder, lane 2 (left) = B. Suis and 11 samples 21 Biovar isolated • Conclusion awaits sequence alignment • But a quick blast search revealed that all the 11 isolates bare a close relationship to Brucella melitensis biovar abortus 2308. This is a wild strain of the rough vaccine strain RB51. 22 Policy Guidance • Urban and peri-urban farmers are advised to keep smaller manageable herds of high producing cattle • Cattle should be bought from brucella free herds, or screened before introduction • Rifampicin remains the drug of choice in treating brucellosis in humans 23 THANK YOU 24